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COVID-19 Impact Assessment Report - NOBO JATRA-NEW BEGINNING - Food ...
NOBO JATRA-NEW BEGINNING
                              USAID’s Development Food Security Activity

                                       COVID-19
                                Impact Assessment Report

                                                    Date: July 13, 2020
                                         © 2020 World Vision Bangladesh. All rights reserved

  This COVID-19 Impact Assessment is made possible by the generous support of the American people through the United States Agency for
International Development (USAID). The contents are the responsibility of World Vision Inc. and do not necessarily reflect the views of USAID
                                                    or the United States Government
CONTENTS
Executive Summary ........................................................................................................................................................... 3
        Health and Nutrition ............................................................................................................................................... 3
        Food Security............................................................................................................................................................. 4
        Water, Sanitation and Hygiene ............................................................................................................................. 5
        Gender ........................................................................................................................................................................ 5
        Livelihoods ................................................................................................................................................................. 5
        Savings ......................................................................................................................................................................... 6
Objectives ............................................................................................................................................................................ 7
Methodology ....................................................................................................................................................................... 7
    Sample design and sampling methods....................................................................................................................... 7
    Sampling frame ............................................................................................................................................................... 8
    Data collection............................................................................................................................................................... 9
    Limitations and lessons learned ................................................................................................................................. 9
Assessment findings......................................................................................................................................................... 10
    1: Household information ......................................................................................................................................... 10
    1: Health and nutrition............................................................................................................................................... 11
    2: Food security ........................................................................................................................................................... 13
    3: Water, Sanitation and Hygiene ........................................................................................................................... 16
    4: Gender ...................................................................................................................................................................... 18
    5: Livelihoods ............................................................................................................................................................... 20
    6: Savings ....................................................................................................................................................................... 23
    7: Markets ..................................................................................................................................................................... 24
    8: Access to information ........................................................................................................................................... 24
    9: Unmet needs............................................................................................................................................................ 26
    9: Conclusion ............................................................................................................................................................... 26

                                                                                                                                                                                        2
EXECUTIVE SUMMARY
The COVID-19 crisis is having macro level impacts on health systems, economies and social
dynamics that will take much longer to recover from. In Bangladesh, lockdowns to prevent
transmission have taken a heavy toll on economies and millions of people are struggling with
poverty and food security. This assessment highlights the impact of COVID-19 on livelihoods,
food security, nutrition and health of poor and extreme poor households covered by USAID’s
Development Food Security Activity ‘Nobo Jatra-New Beginning,’ implemented by World Vision
Bangladesh in Dacope, Koyra, Shyamnagar and Kaliganj sub districts in southwest Bangladesh.
This region is characterized by frequent cyclones – the most recent being cyclone Amphan1 which
made landfall on 20th May 2020 causing damages to 1,327 hectares of crops, 9,404 hectares of
aqua culture2 (fisheries and hatcheries), homes and water sources at a time when communities
are already weakened from the impacts of COVID-19.

On 26 March 2020, the Government of Bangladesh first initiated lockdown measures3 to contain
the pandemic. This impact assessment took place from 21 June – 25 June and highlights the extent
to which Nobo Jatra’s direct participant households are affected. As found through the
assessment, the top priorities for households during the pandemic are:

            Food consumption (81.6%)
            Livelihoods (71.8%)
            Medicines and healthcare (62.2%)
            Water Sanitation and Hygiene (54.4%)

The impact of COVID-19 is evident in the following areas:

Health and Nutrition
    i)        Since the COVID-19 lockdown in March 2020, there has been a sharp
              decrease in the number of people accessing basic primary health services
              through community health structures such as community clinics, expanded
              programme for immunization sites and Union Health and Family Welfare centers.
              These findings are in line with the Bangladesh COVID-19 Multi-Sectoral Impact and
              Needs Analysis4 by the Needs Assessment Working Group, which found that 45% of

1
  A cyclone Amphan impact assessment in Nobo Jatra working areas is underway and the final report will be
shared end July 2020.
2
  Form for Assessment of Damage and Loss, Form - D, Ministry of Food and Disaster Management, May 2020
3 Starting from 26 March 2020, the Government of Bangladesh announced general holidays for a period of two weeks.

The general holiday was extended seven times till 30 May. During this time all Government offices, education
institutions and private companies remained closed. Since 1 June Government offices and other offices have partially
opened and movement restrictions have been relaxed.
4
  COVID-19 Multi-Sectoral Anticipatory Impact and Needs Analysis, Needs Assessment Working Group, April
2020

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020              3
women and children are unable to access health and nutrition services at health
            facilities.
    ii)     The survey found a 31.4 percent decrease in households accessing services at
            community clinics - 91.7% accessed services pre COVID-19 (before lockdown
            started on 26 March) in comparison to 60.3% at present. A 14.5 percent decline was
            seen for access to services through expanded programme for immunization sites –
            85.4% pre COVID-19 and 70.9% now. A drop of 27.1 percent was also seen in
            accessing services from Union Health and Family Welfare Centers (46.8% pre COVID-
            19 and 19.7% now). These are all community level health service delivery points and
            are typically used by poor and extreme poor households in rural Bangladesh - the
            sharp drop in households accessing services is a cause for concern. Whilst services
            were scaled back in March, the main deterrent for communities has been fear of
            exposure to COVID-19 at clinics and centers. Heavy rainfall, flooding due to cyclone
            Amphan and the rainy season and limited public transport options have also been
            constraints in accessing services. Reducing access to basic health care is one of
            the most critical secondary impacts of COVID-19 – and one that increases
            health and malnutrition risks for pregnant and lactating women and
            children under 2.
    iii)    An overwhelming 92% of respondents, both from female and male headed
            households, said they were facing mental stress as a result of the COVID-19
            pandemic. Also, 13% of households said that a family member was going
            through high stress levels due to COVID-19.
    iv)     Of the households with children under 2, more than 50% said they were unable
            to provide a diverse, nutritious diet to the child due to lack of incomes and
            access to markets as a result of COVID-19.

Food Security
    i) The impact assessment found that 56.4% of households had to borrow food or
       relied on help from relatives or neighbors in the previous week. Similarly, 51.7%
       of households ate less preferred, cheaper food impacting daily nutritional intake leading
       to poor nutritional status for children and mothers.
    ii) Household food security also has intersections with gender as the ability of
         women headed households to access safe, nutritious and diverse diets is at
         greater risk as seen through the extent of coping mechanisms used. For example,
         33% of female headed households reduced portion sizes of meals in comparison to 24.7%
         of male headed households.
    iii) Access to a diverse, balanced range of foods is affected due to COVID-19. 67.6% of
         households did not have access to milk products and 46.9% did not have access to protein
         rich foods.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020   4
Water, Sanitation and Hygiene
      i) Access to water for cooking and drinking has decreased from 80.1% to 67.1%
          since the start of the COVID-19 lockdown in March 2020. Also, 74.3% of
          households reported that since COVID-19 it takes longer to collect water due to lengthy
          queues, limited transportation options and specific timings (as per local Government
          instructions) when people can leave their homes. There is also greater pressure on the
          limited number of water resources available due to reverse migration back to rural areas
          and also the damages to water points caused by cyclone Amphan
      ii) In terms of hygiene practices, 82.5% said they were wearing masks when going
          outside their home and 49.7% said they keep their homes and latrines clean. This can
          be attributed to mass awareness efforts by the Government of Bangladesh and Social
          Behavior Change campaigning on COVID-19 by Nobo Jatra.

Gender
      i) Since COVID-19, closure of schools, disrupted or no livelihoods and reverse migration
          back to rural areas has resulted in entire families staying at home which has further
          exacerbated the burden of unpaid care work on women, who now must absorb the
          additional work of constant family care duties. The impact assessment found 57.7%
          of households reported increased time spent on childcare and 51% of households
          are spending more time cooking (unpaid work). Remarkably, 84.7% of households
          reported that husbands or other male caregivers were helping with childcare
          and housework.
      ii) 28% of households reported that risks of child marriage and other forms of
          Gender Based Violence have increased during COVID-19. The current lockdown
          and loss of livelihood may inevitably work as a trigger of domestic violence against women
          and girls. The impact assessment also found that 60% of respondents felt that the safety
          and security of women and girls was a concern in the context of COVID-19.

Livelihoods
      i) As a result of COVID-19, household incomes are adversely affected. A decrease in
         incomes since the previous month was reported by 55.3% of households. Critically, 6.9%
         of households also reported that they had no incomes in the previous month. There are
         important gender differentials in reduced incomes. For example, the number of
         female headed households reporting no incomes was 14.7% in comparison to 5.6% male
         headed households reporting no incomes. This indicates a marked gendered difference of
         the impact of COVID-19 on female headed households bearing in mind that in rural areas
         93.3 % of women typically work in the informal sector5 which is hard hit by the COVID-
         19 pandemic due to lockdown measures.

5
    Bangladesh Bureau of Statistics Labor Force Survey 2016-2017

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020   5
ii) Reduced incomes are also affecting the health, safety and social wellbeing of families. Falling
         sick and being unable to afford treatment was cited by 36.2% of households as one of the
         main knock on effects of reduced incomes.
    iii) Reduced incomes are also having an adverse effect on children’s health, safety and
         wellbeing; 13.7% of respondents said they were sending children out to work, 11.7%
         of respondents said they had to send their children to live with a relative, 5% had to
         send children to religious residential institutions (‘madrassa’s’) and 3.9% had to
         marry their children off early (before the age of 18).

Savings
    i) The COVID-19 impact assessment found that 80.5% of households had no savings.
    ii) To cope with reduced incomes, 12.5% households took loans in the previous
        month – and the average monthly interest rate for these loans is an alarming
        10.9%. The majority of loans were taken from Micro Finance Institutions, followed by
        NGOs, family and local loan sharks. This highlights the urgency to restart and ramp up
        Village Savings Lending Associations so that the most vulnerable families have access to
        equitable finances, without exorbitant and unrealistic interest rates that perpetuate a
        chronic cycle of poverty.

Conclusion
The resilience capacities of Nobo Jatra’s direct participant households are weakened from the
impacts of COVID-19. Government lockdowns to prevent disease transmission have taken a
heavy toll on local economies in southwest Bangladesh - directly affecting livelihoods and incomes
which poses a severe risk to the purchasing power of households and their ability to buy food to
survive. In addition to livelihoods, COVID-19 has affected households’ access to healthcare and
health seeking behaviors, heightened food insecurity and reduced access to safe drinking water.
Critically, Nobo Jatra’s direct participant households are struggling with the effects of COVID-19
and the damages caused by cyclone Amphan which is slowing down their abilities to recover.
Negative coping mechanisms are being used by households such as sending children out to
work, marrying children off before the age of 18, taking loans at high interest rates
and selling productive and household assets. Both in the short and long term, these coping
mechanisms will exacerbate poverty, increase the risks of chronic malnutrition especially for
pregnant and lactating women and children and Gender Based Violence – including child marriage.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020   6
OBJECTIVES
The objectives of the Nobo Jatra COVID-19 Impact Assessment are:

     1. To assess the impact of COVID-19 on food security, livelihoods, nutrition, and health of
        poor and extreme poor households through an equitable, gender sensitive lens.
     2. To assess the capacity of affected populations in order to meet early recovery needs.
     3. To identify specific challenges and gaps that will inform adaptation strategies, influence
        the design of new activities and service delivery models.

METHODOLOGY
The COVID-19 impact assessment is a cross sectional study that covers a representative sample
of Nobo Jatra participants. The sample includes participants across all of the projects technical
components including Water Sanitation and Hygiene, Maternal Child Health and Nutrition,
Agriculture and Alternative Livelihoods, Disaster Risk Reduction, Gender and Good Governance
and Social Accountability.

USAID’s guideline on ‘Participant-Based Surveys for Non Agricultural Annual Monitoring
Indicators6’ has been applied to determine the sample size. Data from the Nobo Jatra Management
Information System (MIS) was used for the sample frame. New, existing and graduated
participants were included in the sample frame as per the participant registration system which
is continuously updated.

SAMPLE DESIGN AND SAMPLING METHODS
A two-stage cluster sampling design was considered for the sample frame. In the first stage of
sampling, villages were randomly selected. In the second stage, a list was generated of households
supported by the project and households were randomly selected from the sampled clusters.
The sample size was adjusted with the design effect for a two-stage Probability Proportional to
Size (PPS7) of the clusters (villages). The procedure to calculate sample size to obtain point
estimation for two-stage cluster sampling is shown below:

                                    z2  p(1  p)
                             n0 
                                          2
6
  Participant-Based Survey Sampling Guide for Feed the Future Annual Monitoring Indicators, September 2018,
page 32
7
  When samples from different sized clusters are used and sampling is taken with the same probability, the chances
of selecting a member from a large cluster are less than selecting a member from a smaller cluster. This is known as
probability proportional to size (PPS). This is offset that larger clusters have greater chance to be in the sample but
the probability of selecting a beneficiary from that cluster is less than the beneficiary in smaller cluster. For example,
if one sample had 20,000 members, the probability of a member being selected would be 1/20000 or .005 percent.
If another sample had 10,000 members, the chance of a member being selected would be 1/10000 or .01 percent.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                    7
Initial sample size:

                                                                              z2  p(1  p)
Final adjusted sample size: n  d  f pc  nr 
                                                                                     2
For Ultra Poor Graduation
 N      = Total number of (Covid-19 assessment beneficiaries                                                                          118,505
 d      = Design effect8                                                                                                              2
 Zα     = Z-score corresponding to the degree of confidence
 P      = Estimated prevalence of an indicator at the time of first survey**                                                          0.50
 ε      = Relative precision required (margin of error 5.5%)                                                                          0.055
nr          = Non-response rate (5%)                                               1.05
n0          = Initial sample size                                                  318
Z95%        = Z value corresponding to 95% confidence level for two-tailed test    1.96
fpc         = Finite population correction factor: 1/ (1+n0/N)                     1.0
            = Adjusted sample size (design effect, non-response, finite population 669
n           correction)                                                            ≈720
nc          = Sample size per village (cluster)                                    16
k           = Number of cluster to be selected                                     45
            ** P attains it's maximum value when it is 0.50 (50%)

SAMPLING FRAME
The sampling frame included:

     i.          Unique ID number for the cluster/village
     ii.         Name of the cluster (e.g., village)
     iii.        Location of the cluster (e.g., census geographic code)
     iv.         Information on geographic location (e.g. district)
     v.          Number of project participants in the cluster

The second stage participant frame included:

     i.          Unique participant and/or household ID number
     ii.         Participant’s complete name
     iii.        Participant’s age and sex
     iv.         Participant’s household location (e.g. address or relative location, GPS coordinates)
     v.          Village name and location
     vi.         Information on geographic location (e.g. district)

8
  The loss of effectiveness by the use of cluster sampling, instead of simple random sampling, is the design effect. The design effect is the ratio
of the actual variance, under the sampling method actually used, to the variance computed under the assumption of simple random sampling.
Usually, the design effect 2.0 is used for a two-stage cluster sampling procedure.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                                             8
45 clusters were selected from Nobo Jatra sub districts and unions using a Probability
Proportional to Size 9 sampling procedure. The first cluster was selected randomly, and the
remaining 44 clusters were selected systematically with probability proportional to the size of
cluster. The minimum required sample from each cluster was 16 participants.

Survey respondents were selected prior to fieldwork using fractional interval systematic sampling
from a comprehensive list of participants using an equal probability method. 16 participants from
the selected 45 clusters were drawn from the sampling frame. Thus (45 X16) 720 households
were selected for the assessment.

DATA COLLECTION
A customized digital application under the Open Data Kit platform was used for data collection.
Data was collected at household level using tablets, Kobo Toolbox and a structured questionnaire.
The impact assessment is guided by the ‘Do No Harm’ principle and seeks to ensure the safety
and confidentiality of individuals and considers that partners and staff in many cases are under
pressure.

LESSONS LEARNED
     i.          Even in a dynamic, evolving pandemic, it was possible to move fast. The impact
                 assessment took 14 days (21st June - 4th July) starting from the development of the
                 questionnaire to the final report.
     ii.         Using digital tools (Kobo Toolbox, tablets) expedited the process as frontline staff
                 have access to and are familiar with using tablets and all data collected is synced with
                 the Nobo Jatra server. Even in a short time frame, taking a systematic approach is
                 critical. For example, in the current situation there are movement restrictions and
                 limitations on gatherings. Therefore, training of staff and data collectors was virtual
                 (using Zoom) and staff from different field locations participated in the training from
                 their respective locations. The virtual training covered data collection processes, tools
                 and revised Standard Operating Procedures on health and safety during COVID-19 –
                 all participants had also participated in online orientation sessions (organized for all
                 Nobo Jatra field staff at the start of the COVID-19 pandemic in March when work
                 from home was first initiated) to increase familiarity with Zoom.

99
    When samples from different sized clusters are used and sampling is taken with the same probability, the chances of selecting a member
from a large cluster are less than selecting a member from a smaller cluster. This is known as probability proportional to size (PPS). This is offset
that larger clusters have greater chance to be in the sample but the probability of selecting a beneficiary from that cluster is less than the
beneficiary in smaller cluster. For example, if one sample had 20,000 members, the probability of a member being selected would be 1/20000
or .005 percent. If another sample had 10,000 members, the chance of a member being selected would be 1/10000 or .01 percent.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                                              9
iii.    Another lesson learned was that deploying a large, well trained team is critical.
            Recognizing that the impact assessment was critical to determine project strategies,
            adaptations and design new activities, 65 field staff (including staff from partners and
            local partner NGOs) were trained and deployed on ground to collect data.
    iv.     Integrating gender throughout the process is crucial. Promising practices include
            having the gender focal point involved in the development of the questionnaire,
            methodology and analysis and an equal balance of male and female staff undertake data
            collection. This helped in highlighting gender issues and will also inform adaptations
            and service delivery models that address specific needs and priorities for women and
            girls. Cyclone Amphan made landfall on 20th May 2020 with gale force winds and heavy
            rains. The scale of damages in Nobo Jatra working areas was immense and have
            exacerbated needs – when communities are already weakened from the prolonged
            impact of COVID-19. Given the flooding and water logging in the aftermath of the
            cyclone, accessibility was a constraint in some unions in Koyra and Shyamnagar sub
            districts.

ASSESSMENT FINDINGS

1: HOUSEHOLD INFORMATION
                       Table 1: Household Information
 Household             Male      Headed Female Headed Total (N)
 Participation in Data Households (N)     Households (N)
 Collection
 Present               594                 101           695
 Temporarily absent    8                   0             8
 Migrated              7                   0             7
 Did not participate   10                  0             5
 Total                 619                 101           720

Of a total of 720 households in the sample, 695 (96.5%) households participated as respondents
in the impact assessment. Ten households chose not participate due to time constraints or a lack
of interest. Among the 695 participating households, 5 (0.7%) were headed by a person aged
below 18 and 87 (12.5%) households were headed by a person aged over 60. The vast majority,
599 (83%), households were headed by persons aged 19-60 years. 125 (18%) of households had
a family member with a disability, 118 (17%) households had a lactating mother and 26 (3.8%) had
a pregnant woman.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020   10
Table 2: Ages of family members in households participating in the assessment
 Age group                 Male                  Female                   Total
 Age
The survey found a sharp decrease in households accessing services at community clinics – 91.7%
pre COVID-19 lockdown in comparison to 60.3% at present. A similar decline was seen
for Expanded Programme for Immunization sites – 85.4% pre COVID-19 and 70.9% now. A drop
of 27.1% was also seen in accessing services from Union Health and Family Welfare Centers (46.8
pre COVID-19 and 19.7% now). All of these health service points are the first point of call for
poor and extreme poor households in rural Bangladesh and the sharp drop in households
accessing series is a cause for concern. Whilst services were scaled back at the start of the
pandemic, the main deterrent has been fear of exposure to COVID-19 at clinics and centers.
Heavy rainfall, flooding due to cyclone Amphan and the rainy season and limited public transport
options have also been constraints in accessing services. Reducing access to basic health
care is one of the most critical secondary impacts of COVID-19 – and one that
increases the risks of malnutrition for pregnant and lactating women and children
under 2. Growth Monitoring Promotion sessions, supported by Nobo Jatra, are one of the main
conduits to track the health and nutrition of children under 2, and provide counselling on Infant
and Young Child Feeding to care givers. Attendance at these sessions are critical and the survey
findings highlight an urgent need to ramp up household counselling and community messaging to
encourage regular attendance, dispel fears of transmission and reassure families that sessions will
follow health and safety protocols for all participants.
                                                    The impact assessment also found that
       Graph 2: Households Facing Mental Stress     79.4% of households knew where to access
    No            due to COVID-19
    7%                                              services if they had symptoms of COVID-
                       Don't know                   19. However, an almost proportional
                           1%
                                                    number, 70.4% of households, said they
                         Yes
                                                    would not access services due to fear of
                         92%                        exposure to COVID-19 and a lack of
                                                    resources to pay for treatment. An
                                                    overwhelming 92% of respondents,
                Yes  No    Don't know               both from female and male headed
                                                    households, said they were facing
mental stress as a result of the COVID-19 pandemic. Also, 13% of households said that a
family member was going through high stress levels due to COVID-19.
Of the households with children under 2, more than 50% said they were unable to provide
a diverse, nutritious diet to the child due to lack of incomes and access to markets
as a result of COVID-19. With regard to immunizations, 17.7% of households mentioned that
they have immunized their children (between 0-23 months) whereas 4% of households could not
immunize their children (between 0-23 months) due to COVID-19.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020   12
2: FOOD SECURITY
COVID‐19 related containment measures in Bangladesh range from basic hygiene
recommendations to lockdowns and movement restrictions designed to limit the concentration
and movement of populations. Movement restrictions and their knock‐on effects have
undermined households’ access to food by limiting the amount of food they can produce or
collect (i.e. crops, milk/meat, and fish); reducing the amount of cash they can generate (from both
on‐farm and off‐ farm sources as described in 2: Livelihoods); and changing the available supplies
and prices of commodities they need to buy, including staple foods, productive inputs and other
essential items.

Seasonality is also an important factor; in Bangladesh containment measures started in end March
when farmers in Nobo Jatra working areas were getting ready to harvest watermelon, bottle
gourd, eggplant and okra. On the production side, restrictions on vehicle movement and home
quarantine, obstructed farmers’ access to markets. Farmers had limited access to inputs such as
seeds and fertilizers, which shortens their productive capacities and hindered them from selling
their produce at the volume and prices anticipated. Supply of inputs such as quality seeds and
presence of the private sector (retailers, input and output buyers), were also disrupted due to
containment efforts. Making matters worse, cyclone Amphan made landfall on 20th May 2020 with
gale force winds and heavy rains. The scale of damages was immense; 1,327 hectares of crops and
9,404 hectares of aqua culture10 (fisheries and hatcheries) were lost across all 4 sub districts
covered by Nobo Jatra.

10
     Form for Assessment of Damage and Loss, Form - D, Ministry of Food and Disaster Management, May 2020

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020        13
Graph 3: Food Security Coping Strategies (previous 7 days)
 60           56.6 56.4
       55.1                      52.3 51.7
 50                       48.2

 40
                                             33               32.4
 30                                               24.7 25.9                     25.1
                                                                  20.6 22.3            21    21.6
 20

 10
                                                                                                        2.9 1.6 1.8
  0
       Borrowed food or Relied on less       Reduced portions Reduced number Buy food on credit Went an entire day
      relied on help from preferred, cheaper                  of meals per day                   without eating
           relatives,            food
           neighbors

                     Women headed households (%)         Men headed households (%)          Total (%)

The impact assessment found that 56.4% of households had to borrow food or relied on
help from relatives or neighbors in the previous week. Similarly, 51.7% of households ate
less preferred, cheaper food. Household food security also has intersections with gender
as the ability of women headed households to access safe, nutritious and diverse diets
is at greater risk as seen through the extent of coping mechanisms used. For example,
33% of women headed households reduced portion sizes of meals in comparison to 24.7% of
men headed households. Households also reported reducing the number of meals as a coping
mechanism - with 32.4% of women headed household using this tactic in comparison to 20.6% of
men headed households.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                       14
Graph 4: Behaviors due to lack of food (previous 30 days)
 60     57.1
           50.3 51.4
 50

 40

 30                    25.2 24.7
                                 24.7
                                            19.4
 20                                     16.7     17.1
                                                         14.5 13.4 14.4                             13.4
                                                                          12.7 13.2 13.1
                                                                                                           12.3
 10                                                                                           5.7

  0
      Borrowed money   Used savings      Reduced non    Sold livestock or    Sold last     Sold household
           or food                      food expenses       poultry       remaining female      assets
                                                                             livestock

                  Women headed household (%)       Men headed household (%)         Total (%)

To meet immediate household consumption needs, 51.4% of respondents reported taking loans
or borrowing food in the previous 30 days. The impact assessment showed that 57.1% of women
headed households had borrowed food or money in the previous 30 days in comparison to 50.3%
of men headed households.
Selling livestock and household assets such as jewelry, furniture, radios were all reported ways in
which households were meeting consumption needs in the previous 30 days to the survey. This
is further depleting household resilience capacities – particularly when it comes to paying medical
treatments or reviving livelihoods that are affected by the double impacts of COVID-19 and
cyclone Amphan.
Remarkably, 43.5% of households surveyed had no food provisions or stock. Again, there are
marked gendered differentials; 60.7% of female headed households reported having no food
supplies or stock in comparison to 40.5% of male headed households. Having food supplies for 1
week was reported by 33.6% of households – with 24.2% of women headed households reporting
this in comparison to 35.2% of men headed households.
                                Table 4: Availability of food groups
 Available food        Male headed (%)     Female headed (%)   Total
 groups                Yes    No Sometimes Yes    No Sometimes Yes                                  No        Sometimes

 Starch (Cereals,      45.3    19.4        35.2         32.2   33.2        34.6        43.4         21.4          35.1
 rice, flour, bread,
 potato, sweet
 potato)

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                     15
Protein rich         10.0       45.2         44.8        7.5       56.6     35.9         9.6   46.9         43.5
 animal source
 foods (eggs, fish,
 meat)
 Pulses and           20.4       39.5         40.1        15.5      43.9     40.6       19.6    40.2         40.2
 legumes
 Green leafy          53.8       19.4         26.9        40.5      24.0     35.5       51.9    19.9         28.1
 vegetables
 Other vegetables     35.0       30.3         34.7        21.4      46.1     32.5       33.0    32.5         32.4
 and fruits
 Energy dense         24.3       37.7         38.0        22.0      42.9     35.1       23.9    38.5         37.6
 foods (oil, nuts,
 sugar)
 Milk products          7.7      61.6         24.7        4.7       74.4     20.9         7.2   67.6         25.1
 (fresh Milk,
 margarine,
 butter)

Access to a diverse, balanced range of foods is also affected due to COVID-19. As shown in Table
3, 67.6% of households did not have access to milk products and 46.9% did not have access to
protein rich foods. This correlates to food security coping mechanisms used by families – where
51.7% of households reported eating cheaper, less preferred food (Graph 4: Food Security and
Coping Strategies in previous 7 days). Once again, female headed households reported these
constraints on dietary diversity to a higher extent than male headed households (74.4% of female
headed households were unable to consume milk products in comparison to 61.6% of male
headed households).

3: WATER, SANITATION AND HYGIENE
Safe water, sanitation and hygienic conditions are essential for protecting health during all
infectious disease outbreaks, including COVID-19. Now, more than ever, households need access
to safe drinking water and hygienic latrines.
        Table 5: Households able to meet needs for clean, safe, drinking water
                              Before COVID-19                              Since COVID-19
 Household water
 needs
                              Fully     Partially    Not        Don't      Fully    Partially   Not      Don't
                                                     at all     know                            at all   know
 Drinking and cooking         80%       19%          1%         -          67%      30%         3%       -
 Latrines                     66%       31%          3%         -          58%      39%         3%       -
 Handwashing                  78%       19%          3%         -          47%      51%         2%       -
 Bathing and personal         70%       27%          3%         -          56%      40%         3%       1%
 hygiene

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                16
Household cleaning        70%     27%         2%      1%          50%      47%         2%        1%
 Livelihoods               39%     31%         20%     10%         27%      42%         21%       10%
 (irrigation, livestock)

                                                            Across all categories we see a drop
        Graph 5: Time needed to collect water               in access to clean, safe water since
                     since COVID-19                         COVID-19. Access to water for
                                                            cooking and drinking has
                                                            decreased from 80% to 67% the
                           9.1
                                                            start      of     the     COVID-19
                      16.6                                  lockdown on 26 March 2020.
                                                            Similarly, there is a drop in access to
                                                            water for handwashing, bathing,
                                   74.3
                                                            cleaning and for livestock. This can
                                                            be attributed to restrictions on
                                                            movement due to COVID-19,
                 Longer    No change    Shorter             limited transportation options also
                                                            greater pressure on the limited
number of water resources available due to reverse migration back to rural areas and also the
damages to water points caused by cyclone Amphan. Poor and extreme poor populations
covered by Nobo Jatra typically rely on community water points (deep tube wells, shallow tube
wells, pond sand filters, Reverse Osmosis plants, Arsenic Iron Removal plants). People, typically
women and adolescent girls, have been unable to leave their homes as frequently as needed to
collect water from water points. Also, 74.3% of households reported that since COVID-
19 lockdown measures in March it takes longer to collect water due to long queues,
specific timings (as per local Government instructions) and greater pressure on
limited number of resources due to reverse migration back to rural areas.
Access to safe sanitation has also dropped 8.2% from 66% pre COVID-19 lock down measures
in March to 57.8% now. Households also confirmed a drop in being able to meet bathing and
personal hygiene needs – 70% were able to meet these needs pre COVID-19 lockdown
restrictions in comparison to 55.9% now. Access to water for livestock and irrigation purposes
has also been affected – 38.9% of households were able to fully meet needs prior to COVID-19
in comparison to 27.6% now.
In terms of hygiene practices, 82.5% said they were wearing masks when going outside their home
and 49.7% said they keep their homes and latrines clean. This can be attributed to mass Social
Behavior Change campaigning by the Government of Bangladesh and NGOs. Bearing in mind that
households are directly involved with Nobo Jatra, these hygiene behaviors can also be credited
to multiple awareness activities including voice messages on health and hygiene, household

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020         17
counselling, public awareness messaging at community level and through faith leaders and religious
institutions.

4: GENDER
Whilst lifesaving, the COVID-19 lockdown is disproportionately impacting women as existing
gender inequalities are exacerbating gender-based disparities between women, men, girls and
boys in terms of access to information, resources to cope with the pandemic, and its socio-
economic impact.

                       Graph 6: Increase in housework and caregiving

                                                                                                          86.9
                   Cleaning                                                                                87.3
                                                                                                         84.8

                                                   25.3
 Buying or collecting food                         25
                                                    26.9

                                               20.8
             Care of elderly                   21
                                            16.7

                                                                                     57.7
                  Childcare                                                             61.1
                                                                  37.2

                                                                              51
                   Cooking                                                         54.3
                                                           31.5

                                0    10     20        30      40         50         60         70   80    90      100

                    Total (%)       Men headed households (%)            Women headed households (%)

COVID-19 has increased the burden of unpaid domestic and childcare work for everyone,
especially for mothers or female caregivers. In Bangladesh, pre-COVID-19, women on average
performed 3.43 times more unpaid domestic care work than men (Bangladesh Bureau of Statistics
Gender Statistics 2018) 11 . Since COVID-10, closure of schools, disrupted or no livelihoods,
reverse migration back to rural areas has resulted in entire families staying at home which has
further exacerbated the burden of unpaid care work on women, who now must absorb the
additional work of constant family care duties. The impact assessment found that 86.9% of
households reported increased time on cleaning (unpaid work). This can be attributed
to having additional family members at home and massive COVID-19 health and hygiene
awareness by the Government of Bangladesh and NGOs. 57.7% of households also reported
increased time spent on childcare and 51% of households are spending more time cooking.

11
     Bangladesh Bureau of Statistics Gender Statistics 2018

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                         18
Remarkably, 84.7% of households reported that husbands or other male caregivers were helping
with childcare and housework.
                                                                         Increases in Gender Based
          Graph 7: Awareness of Gender Based Violence
                                                                         Violence is a real risk in the
          and Child Marriage Incidents during COVID-
                                                                         context of a dynamic, evolving
                               19
                                                            28           pandemic.        In      southwest
  30
                                                                         Bangladesh, child marriage is a
  20
              5.5
                                                                         critical challenge and the average
  10                                  3.4
                                                                         age of marriage for women is
   0
        GBV in the last 3   Child marriage in the Child marriage and     15.212. Since 2015, Nobo Jatra has
            months              last 3 months     GBV risks increased in taken a holistic approach to
                                                    the last 3 months
                                                                         address this challenge; working to
                          % of households aware of                       strengthen Government Child
                                                                         Protection Committees, rolling
out a deeply contextualized Male Engagement for Gender Equality module, a ‘Marriage Not
Before 18’ awareness campaign and running Life Skills Based Education in communities and
schools. Messaging on Gender Based Violence is also intentionally integrated across all Social
Behavior Change activities cutting across all components. However, given the impacts of COVID-
19, 28% of households reported that risks of child marriage and other forms of
Gender Based Violence have increased during COVID-19. However, it is worth noting
that the actual number of cases are never known; and the Multiple Indicator Cluster Survey 201913
found that 25.4% of women think partner (husband) violence is justified. The current lockdown
and loss of livelihood would inevitably work as a trigger of domestic violence against women and
girls. The impact assessment also found that 60% of respondents felt that the safety and security
of women and girls was a concern in the context of COVID-19.This aligns with the Bangladesh
Needs Assessment Working Groups’ Anticipatory Assessment Report which showed that 49.2%
of women and girls feel safety and security is an issue in the current lockdown
In terms of reporting of child marriage and Gender Based Violence, 62.1% of households know
where and how to report cases (government toll free hotlines, local police and local Government
administrations).

12
     Nobo Jatra Baseline 2015
13
     https://www.unicef.org/bangladesh/en/reports/progotir-pathey-bangladesh

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020      19
5: LIVELIHOODS14
                  Graph 8: Status of Livelihoods Pre COVID-19 and Present

                                     5.8
          Rickshaw van puller
                                      6.5

                                     5.1
         Fisheries day laborer
                                           8.1

                                                 15.7
      Agricultural day laborer
                                                        21.5

                                                                                             64.2
                    Day labor
                                                                                                     72.1

                                 0     10          20          30      40      50      60       70          80

                                                 At present     Pre COVID-19

Of the surveyed households, 72.1% of households said working as a day laborer (casual labor
construction, repair of roads, houses, digging ponds, canals) was their main source of income pre
COVID-19 lockdowns that started in March. The second most prevalent livelihood pre COVID-
19 was working as a agriculture day laborer (working on farms, agricultural lands) and 21.5%
households said this was their main source of income. Both of these livelihoods are still the most
popular however, both have seen a drop – only 64.7% households continue to rely on day labor
and 15.7% households rely on agricultural day labor as their main sources of income. The drop
in all livelihoods can be attributed to a number of factors; Government lockdown measures to
reduce the risk of COVID-19 transmission, suspended services (for example, construction work
which requires day laborers) and also the damages caused by cyclone Amphan to harvests,
agricultural lands and aquaculture (reducing the need for agriculture day laborers).

14
  Livelihoods includes Agriculture and Alternative Livelihoods of off-farm and non-farm activities, both wage labor
and enterprise income.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                  20
Graph 9: Previous Months Income Status
 60        56.4    55.3
               49.1
 50

 40
                                  31.6
                              29.2 29.6
 30

 20                                                                                                           14.7

 10                                                                                  5.7                5.6          6.9
                                                2.6      2.3                               3.6 5.4
                                                                   0.5 1 0.6
     0
             Incomes            Incomes           Incomes            Incomes       Income remained      No income
         decreased a little    decreased      increased a little    increased          the same
                              significantly                        significantly

                      Men headed households (%)          Women headed households (%)            Total (%)

Linked to the status of livelihoods, just over half or 55.3% households reported a decrease in
incomes since the previous month. Moreover, 29.6% households said that incomes had decreased
significantly since the previous month. It is worth noting that, 6.9% households also reported
that they had no incomes in the previous month. As a result of COVID-19, household
incomes are adversely affected, however, there are gender differentials. For example, the number
of female headed households reporting no incomes was 14.7% in comparison to 5.6% male headed
households reporting no incomes. This indicates a marked gendered difference of the impact of
COVID-19 on female headed households bearing in mind that in rural areas 93.3 % of women
typically work in the informal sector 15 which is hard hit by the COVID-19 pandemic due to
lockdown measures. For example, women entrepreneurs (tailors, embroiderers, paper box and
handicraft businesses) have all seen their businesses suffer since the lockdown restrictions were
put in place. Orders have reduced or stopped altogether, women have used up business capital
to meet immediate household needs and now are unable to restart livelihoods as do not have
seed capital to purchase raw materials needed (paper for boxes, cloth and thread for tailoring
etc.)

The majority of respondents, 94.1% of households reported that livelihoods were adversely
affected as a result of COVID-19. The main reason attributed to disrupting livelihoods were:
closure of businesses (48.6%), lockdown, movement restrictions (45%), reduced demands for

15
     Bangladesh Bureau of Statistics Labor Force Survey 2016-2017

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                            21
goods and services (37.7%), transport limitations (36.6%), market closures (34.4%), unavailability
of inputs (21.7%) and unaffordability of inputs (16.2%).

                                 Graph 10: Coping with Reduced Incomes

                 Lease out land or livestock                3.2

                        Advance selling labor                           7

 Loans from Community Based Organizations                                               11.7

                         Sell household items                                           11.9

           Borrow from relatives, neighbors                                                    14

                     Sold productive assets                                                    14.3

                            Sold land or trees                                                        16.25

                                Used savings                                                                  18.5

                                                 0                5               10           15              20            25

                         Total (%)      Men headed households (%)            Women headed households (%)

Reduced incomes are also affecting the health, safety and social wellbeing of families. Falling sick
and being unable to afford treatment was cited by 36.2% of households as one of the main knock
on effects of reduced incomes. Engaging in high risk jobs (such as fishing in Sundarbans) was also
cited by 26.2% of households as a way of mitigating reduced incomes. Reduced incomes are also
having an adverse effect on children’s health, safety and wellbeing; 13.7% of respondents
said they were sending children out to work, 11.7% of respondents said they had to
send their children to a relative, 5% had to send children to religious residential
institutions (‘madrassa’s’) and 3.9% had to marry their children off early (before the
age of 18).

                                       Table 3: Household affordability
                                                      Before COVID-19                           Since COVID-19
  Category                                 Fully         Partially    Not at all       Fully   Partially        Not at all
 Food                                        66%           32%           2%             11%       81%                2%
 Cooking items (gas, wood)                      69%        20%              3%         22%          70%              5%
 Rent (if applicable)                           13%        11%              11%         6%          17%              12%
 Healthcare                                     65%        32%               2%        15%          75%               8%
 Loan payment                                   35%        22%              12%         7%          34%              27%

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                         22
Personal hygiene and sanitation      53%        43%          2%        27%        62%            9%
 products
 Others items                         48%        38%          3%        14%        68%            7%

Reduced incomes are drastically affecting the ability of households to afford basic living essentials.
There are dramatic drops in affordability pre COVID-19 in comparison to the present. Families
are struggling to afford food – 66% of households were able to fully meet their food costs prior
to COVID-19 in comparison to 11% now. The drop in healthcare affordability is also notable –
65% were able to cover costs fully prior to COVID-19 in comparison to only 15% of households
now.

6: SAVINGS
Now more than ever, savings are critical to counter personal financial crises and unforeseen
risks,and increase chances of staying resilient. However, the COVID-19 impact assessment found
that 80.5% of households had no savings. Furthermore, 84.1% of households headed by
women had no savings in comparison to 79.9% of households headed by men. Again, this shows
the gendered differences of the impact of COVID-19 on households – with female headed
households disproportionally affected.

To cope with reduced incomes, 12.5% households took loans in the previous month –
and the average interest rate for these loans is 10.9%. The main reason for taking loans
was to meet immediate household consumption needs, followed by medical treatment and
repaying other outstanding loans. The majority of loans were taken from Micro Finance
Institutions, followed by NGOs, family and local informal money lenders. This highlights the
urgency to restart and ramp up Village Savings Lending Associations so that the most vulnerable
families have access to equitable finances, without exorbitant and unrealistic interest rates that
perpetuate a chronic cycle of poetry. Equally, this also emphasizes the need to revive incomes
and livelihoods through creative service delivery models (such as cost share mechanisms,
incentivizing private sector, demand creation campaigns).

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020    23
7: MARKETS
                                                                                            Local markets have
            Graph 11: Consistent Availability of Essential Items in Markets
                                                                                            largely   remained
                              Before COVID-19       Since COVID-19
100%                                                                                        open since the start
                                   87%                    87%               85%
 90%        82%                                                                             of the lockdown in
 80%                                                                                        end March – albeit
 70%                                                                                        for shorter hours,
 60%
                                                                  50%                       on certain days and
                                                                                    45%
 50%                                                                                        in some cases in
 40%                                                                                        Nobo Jatra working
 30%
                    20%                    21%                                              areas markets have
 20%                                                                                        been shifted to
 10%                                                                                        open areas where it
  0%                                                                                        is easier to follow
       Fresh food items (e.g. Basic food items (e.g. Hygiene items (e.g. Essential medicine
       vegetables, eggs, meat) rice, bread, flour)      soap, detergent)                    social    distancing
                                                                                            rules.    However,
availability of fresh foods, dry foods, hygiene items and essential medicines have not been
consistent in local markets due to restrictions on vehicle movement and home quarantine,
farmers’ access to markets is obstructed and disruptions to transport of goods between different
areas of the country.

8: ACCESS TO INFORMATION
One of the objectives of the impact assessment was to determine preferred ways for households
to access information on COVID-19 so that Nobo Jatra can adapt Social Behavior Change
strategies based on this.

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020          24
Graph 12: Access to Information on COVID-19
 70
             60.7
                    59.2
 60
      50.7
 50

 40                               34.3
                           32.8          34.1          30.8            32.7
                                                28.4          30.5 29.9     30.3      26.4
 30
                                                                                             25.6          22.5
                                                                                   20.8             23.7          22.7
 20                                                                                                                                16.7
                                                                                                                         17.4 13.2
 10

  0
      Local radio and World Vision Mobile phones                      Family       Social media        Posters              Village
         cable TV     Bangladesh       (text                                                                             Development
                                    messages)                                                                            Committees

                      Women headed households (%)                     Men headed households (%)              Total (%)

The overwhelming preference for information on COVID-19 is through community radio and
local cable TV channels. This was followed by information from World Vision Bangladesh – as
households were familiar with and trusted the organization to provide accurate and helpful
information on COVID-19. Messages through mobile phones – text messages in particular were
also popular as a source of information. 13.4% of respondents also said they found voice messages
provided by Nobo Jatra useful (bearing in mind that only 44,600 participants receive this service).

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                                           25
9: UNMET NEEDS
                          Graph 13: Critical Needs Going Forward
 100
  90     86.4
                80.8   81.6
  80
                                71 71.9
                                          71.8
  70                                              61.7          62.2
                                                         62.3
  60                                                                          55.2
                                                                       49.4          54.4
  50
  40
                                                                                                 27.3
  30
                                                                                                        17.3 18.7
  20
  10
   0
        Immediate food        Support to revive    Healthcare             WASH                     Education
         consumption             livelihoods

                   Women headed households (%)       Men headed household (%)               Total (%)

The most immediate pressing need is for support with household food consumption – 81.6% of
respondents identified this as a top priority. Reviving livelihoods was also a critical concern for
71.8% of households – who are anxious to recover from the prolonged disruption to or loss of
incomes caused by COVID-19. It is worth noting that 49.1% of households prefer to receive cash
transfers through e wallets linked to mobile phones and 33.9% prefer direct cash assistance.

9: CONCLUSION
Impact of COVID-19 on health, nutrition, food security and livelihoods of poor and
extreme poor households
The resilience capacities of Nobo Jatra’s direct participant households are weakened from the
impacts of COVID-19. Government lockdowns to prevent disease transmission have taken a
heavy toll on local economies in southwest Bangladesh - directly affecting livelihoods and incomes
which poses a severe risk to the purchasing power of households and their ability to buy food to
survive. In addition to livelihoods, COVID-19 has affected households’ access to healthcare and
health seeking behaviors, heightened food insecurity and reduced access to safe drinking water.
Critically, Nobo Jatra’s direct participant households are struggling with the effects of COVID-19
and the damages caused by cyclone Amphan which is slowing down their abilities to recover.
Negative coping mechanisms are being used by households such as sending children out to
work, marrying children off before the age of 18, taking loans at high interest rates
and selling productive and household assets. Both in the short and long term, these coping

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020                     26
mechanisms will exacerbate poverty, increase the risks of chronic malnutrition especially for
pregnant and lactating women and children and Gender Based Violence – including child marriage.

Access to basic primary healthcare at community health structures such as community clinics,
expanded programme for immunization sites and at Union Health and Family Welfare centers
has decreased since the start of COVID-19 lockdown measures in March. Whilst Government
health services were initially scaled back in March, the main deterrent for communities has been
fear of exposure to COVID-19 at clinics and centers. Reduced access to basic health care
is one of the most critical secondary impacts of COVID-19 – and one that increases
health and malnutrition risks for pregnant and lactating women and children under
2. Household food insecurity is also compounded mainly due to lower household incomes,
reduced availability of fresh and dry foods in markets resulting in households opting for cheaper,
less nutritious food. This also has implications for health and nutrition for future generations.

Access to drinking water through community based water points has also decreased since the
start of the COVID-19 lockdown in March 2020. Households have also reported that since
COVID-19 it takes longer to collect water due to lengthy queues, limited transportation options
and specific timings (as per local Government instructions) when people can leave their homes.
There is also greater pressure on the limited number of water resources available due to reverse
migration back to rural areas and also the damages to water points caused by cyclone Amphan.

The impact of COVID-19 on the livelihoods and incomes of rural poor households is critical.
The majority, 91.8% of households, confirmed that incomes were reduced. Female headed
households are most affected by loss of incomes given that in rural areas 93.3 % of women
typically work in the informal sector16 which is hard hit by the COVID-19 pandemic. Reduced
incomes are also affecting the health, safety and social wellbeing of families. Falling sick and being
unable to afford treatment was cited by 36.2% of households as one of the main knock on effects
of reduced incomes.

The findings of the impact assessment have provided rich information that will help Nobo Jatra
influence the design of new activities and service delivery models and to adapt
existing activities to better meet the needs of affected households. The findings of this
Impact Assessment have informed the design activities in the submitted 12 months bridge phase
cost extension. Recommendations are aligned to the key findings in the assessment:
    1. Address immediate urgent needs and strengthen resilience capacities of the
       most vulnerable households
       Multi-Purpose Cash Grants targeted to the most vulnerable households, including
       those with pregnant and lactating women and children and extreme poor households, are

16
     Bangladesh Bureau of Statistics Labor Force Survey 2016-2017

WV, Nobo Jatra, AID-FFP-A-15-00012, COVID-19 Impact Assessment Report, Submitted July 13 - 2020   27
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